Color-Coded Cerebral Computed Tomographic Angiography. Issue 5 (May 2015)

• Record Type: Journal Article
• Authors: Thierfelder, Kolja M.; Havla, Lukas; Beyer, Sebastian E.; Ertl-Wagner, Birgit; Meinel, Felix G.; von Baumgarten, Louisa; Janssen, Hendrik; Ditt, Hendrik; Reiser, Maximilian F.; Sommer, Wieland H.
• Is Part Of: Investigative radiology. Volume 50:Issue 5(2015:May)
• Publication Date: 2015-05
• Subjects: Diagnosis, Radioscopic -- Periodicals; Radiology, Medical -- Periodicals; 616.0757
• DOI: 10.1097/RLI.0000000000000134
• Languages: English
• ISSNs: 0020-9996

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective</title> <p>The objective of this study was to develop a new method of displaying dynamic cerebral computed tomographic (CT) angiography (CTA) data sets in which the time delay to maximum enhancement (T<sub>delay</sub>) is displayed in a range of colors (color-coded CT angiography [cCTA]).</p> </sec> <sec> <title>Materials and Methods</title> <p>This institutional review board-approved study included multiparametric CT data sets from 16 patients with different types of supra-aortic large vessel occlusions. Color-coded CT angiography was reconstructed from CT perfusion raw data sets. All voxel enhancement curves were fitted to f(t) = α · AIF<sub>mtt</sub>(t − Δt), with AIF<sub>mtt</sub>(t), indicating enhancement of AIF dilated by convolution with boxcar function (with mean transit time [mtt]); α, scaling factor; and [INCREMENT]t, transition along the time. The time delay to maximum enhancement was defined as T<sub>delay</sub> = Δt +0.5 · mtt. Values of T<sub>delay</sub> were color-coded and superimposed on temporal maximum intensity projections CTA resulting in colored angiographic composite images. For a pilot clinical evaluation, diagnostic confidence in determining the pathology, quality of the visualization of leptomeningeal collaterals, and additional diagnostic information were assessed.</p> </sec> <sec> <title>Results</title> <p>The reconstruction of cCTA was technically feasible in all 16 patients. Both diagnostic confidence (<italic>P</italic> < 0.01) and the quality of the visualization of collaterals (<italic>P</italic> < 0.0001) were significantly higher when using the combination of single-phase CTA and cCTA compared with single-phase CTA alone. Additional diagnostic information was obtained with cCTA regarding occlusion type (reader 1: 5 cases and reader 2: 4 cases), differentiation between arteries and veins (11/13), differentiation between antegrade and retrograde filling (12/13), as well as leptomeningeal collateralization (13/14).</p> </sec> <sec> <title>Conclusions</title> <p>Color-coded CT angiography is a technically feasible technique that provides additional information on cerebral hemodynamics in ischemic stroke patients.</p> </sec> </abstract>